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Universal newborn hearing screening in the Italian Region of Sicily in 2018
Salvatore Ferlito1, Antonino Maniaci1, Salvatore Cocuzza1
1Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy.
Insights
Universal Neonatal Hearing Screening (UNHS) in Sicily identified 1.5% of newborns with permanent hearing loss in 2018. This study highlights screening effectiveness and areas for improvement in early diagnosis and treatment.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Universal Neonatal Hearing Screening (UNHS) is crucial for early diagnosis and treatment of hearing loss in infants.
- Effective implementation of UNHS can improve long-term outcomes for deaf children and reduce healthcare costs.
- Data on UNHS effectiveness in Sicily is limited, necessitating local monitoring.
Purpose of the Study:
- To evaluate the effectiveness and adherence of the Universal Neonatal Hearing Screening program in Sicily for the year 2018.
- To collect data on the number of newborns screened, referred for further testing, and diagnosed with permanent hearing loss.
- To identify critical areas and propose solutions for improving the UNHS program in Sicily.
Main Methods:
- Data collection through questionnaires for UNHS monitoring in Sicily.
- Analysis of screening program effectiveness and adherence by the Department for Health Activities and the Epidemiological Observatory (DASOE).
- Evaluation of screening outcomes including transiently evoked otoacoustic emissions (TEOAE) and auditory brainstem response (ABR) results.
Main Results:
- In 2018, 93.3% (37,562/40,243) of newborns in Sicily were screened.
- 3.5% of screened infants were referred for TEOAE, with 18.6% of referred infants not completing the second-level screening.
- A total of 1.5% of screened infants were diagnosed with permanent hearing loss (60/37,562).
Conclusions:
- Monitoring UNHS in Sicily provided essential data previously unavailable in the literature.
- The study verified the screening's effectiveness according to Joint Committee on Infant Hearing (JCIH) criteria.
- Identified critical issues within the screening process and suggested potential improvements for the program.
Objectives:
We have clarified the role of Universal Neonatal Hearing Screening (UNHS) for both early diagnosis and rapid treatment in order to improve the prognosis of the deaf child and reduce patient management costs. Although in Sicily UNHS has been progressively implemented, there is scarce data in the literature on this matter. Therefore, the main objective was to collect in the year 2018 the following data: number of newborns screened for hearing loss, number of infants "referred" to transiently evoked otoacoustic emissions (TEOAE), number of infants with pathologic auditory brainstem response (ABR) and number of infants affected by permanent hearing loss.
Methods:
UNHS monitoring was conducted through the collection of data through a questionnaire, which was analysed evaluating the effectiveness and adherence to the screening program prepared by the Department for Health Activities and the Epidemiological Observatory (DASOE).
Results:
In 2018, there were 40,243 newborns in Sicily. A total of 37,562 newborns were screened (93.3%). There were 1,328 "referred" infants with TEOAE (3.5%). On the 2nd level, "referred" newborns examined were 1,080 of 1,328 expected (missing 248 "refer" newborns, equal to 18.6%). The number of "referred" infants confirmed with TEOAE was 113 of 1,080, while "referred" infants confirmed with ABR were 71. On the 3rd level, 67 of 71 were infants examined: 28 infants were suffering from monolateral hearing loss (13 slight/mild, 13 moderate, 1 severe and 1 profound) and 39 from bilateral hearing loss (1slight/mild, 19 moderate, 13 severe and 7 profound). Excluding 7 infants from the NICU, 60 of 37,562 infants had hearing loss (1.5%).
Conclusions:
The monitoring of the UNHS in Sicily has allowed obtaining the data of individual centres, absent in the literature to date, to verify the effectiveness of the screening, according to JCIH criteria, to highlight some criticalities and, finally, to propose possible solutions.
